Heather Yakin: Database a step in taking action to curb drug abuse

New York's new tool to combat prescription drug abuse, the Internet System for Tracking Over-Prescribing, has been in operation since August, and Gov. Andrew Cuomo announced this week that it's going gangbusters.

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Posted Feb. 5, 2014 at 2:00 AM

Posted Feb. 5, 2014 at 2:00 AM

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New York's new tool to combat prescription drug abuse, the Internet System for Tracking Over-Prescribing, has been in operation since August, and Gov. Andrew Cuomo announced this week that it's going gangbusters.

I-STOP, as the database is more commonly known, requires health-care professionals to check the real-time system before prescribing controlled substances listed as Schedule II, III or IV. Those categories include prescription opioid painkillers as well as benzodiazepines and a host of other medications.

Basically, pharmacists report, via the 24-7 Prescription Monitoring Program, the prescriptions they have filled. The PMP holds six months of prescription data. Before writing a new scrip, doctors and other prescribers check the database to look for patterns that would suggest doctor-shopping or unusually heavy use of a drug.

Before I-STOP, the state reporting and check system were voluntary. In the three years preceding I-STOP, Cuomo announced, a total of 5,096 practitioners did a total of 465,930 prescription searches. Since the Aug. 27, 2013, full launch of I-STOP, 66,369 health professionals ran nearly 7 million searches for 2,879,140 individual patients.

Cuomo's office says that for the fourth quarter of 2013 versus the fourth quarter of 2012, there was "a 74.9 percent decrease in the number of individuals engaged in doctor-shopping."

Overdose and addiction-treatment data are not yet available.

I'm not sure what the baseline level is of drug-seeking doctor-shopping, but I do know that studies have shown that a fairly small percentage of people who get prescriptions for opioids are responsible for the lion's share of doctor-shopping behavior.

Taking action to curb abuse of prescription painkillers and anti-anxiety meds is good and necessary — not only for society, because of the toll of addiction — but also for people who have real medical need for the drugs. The actions of scammers put legitimate pain patients under a microscope.

I worry about another unintended consequence of I-STOP. An opiate addiction doesn't go away just because a person suddenly loses access to prescriptions, and heroin is cheap and plentiful.

Police and the medical community have already reported addicts increasingly turning to heroin. Last week's big Orange County drug-and-gun raids turned up plenty of heroin.

Meanwhile, cops all over the Eastern Seaboard — including here — are seeing rashes of overdoses from heroin laced with the very powerful synthetic opioid Fentanyl.

If I-STOP ultimately quashes prescription opioid access but heroin deaths skyrocket, then I-STOP's achievement will be at best a Pyrrhic victory.